scholarly journals Sleep Quality Is Related to Worsening Knee Pain in Those with Widespread Pain: The Multicenter Osteoarthritis Study

2019 ◽  
Vol 47 (7) ◽  
pp. 1019-1025 ◽  
Author(s):  
Zhaoli Dai ◽  
Tuhina Neogi ◽  
Carrie Brown ◽  
Michael Nevitt ◽  
Cora E. Lewis ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Knee Pain ◽  
The Body ◽  
Womac Pain ◽  
Widespread Pain ◽  
Cross Sectional ◽  
Painful Joint ◽  
Logistic Regression Models ◽  
American College Of Rheumatology ◽  
The Relationship

Objective.We examined the association between sleep and odds of developing knee pain, and whether this relationship varied by status of widespread pain (WSP).Methods.At the 60-month visit of the Multicenter Osteoarthritis Study, sleep quality and restless sleep were each assessed by using a single item from 2 validated questionnaires. Each sleep measure was categorized into 3 levels, with poor/most restless sleep as the reference. WSP was defined as pain above and below the waist on both sides of the body and axially using a standard homunculus, based on the American College of Rheumatology criteria. Outcomes from 60–84 months included (1) knee pain worsening (KPW; defined as minimal clinically important difference in WOMAC pain), (2) prevalent, and (3) incident consistent frequent knee pain. We applied generalized estimating equations in multivariable logistic regression models.Results.We studied 2329 participants (4658 knees; 67.9 yrs, body mass index 30.9]. We found that WSP modified the relationship between sleep quality and KPW (p = 0.002 for interaction). Among persons with WSP, OR (95% CI) for KPW was 0.53 (0.35–0.78) for those with very good sleep quality (p trend < 0.001); additionally, we found the strongest association of sleep quality in persons with > 8 painful joint sites (p trend < 0.01), but not in those with ≤ 2 painful joint sites. Similar results were observed using restless sleep, in the presence of WSP. The cross-sectional relationship between sleep and prevalence of consistent frequent knee pain was significant.Conclusion.Better sleep was related to less KPW with coexisting widespread pain.

scholarly journals The WOMAC Pain Scale and Crosstalk From Co-occurring Pain Sites in People With Knee Pain: A Causal Modeling Study

2020 ◽  
Vol 100 (10) ◽  
pp. 1872-1881
Author(s):  
Daniel L Riddle ◽  
Robert A Perera
Keyword(s):  
Knee Pain ◽  
Pain Scale ◽  
Causal Modeling ◽  
The Body ◽  
Test Theory ◽  
Coefficient Of Determination ◽  
Womac Pain ◽  
Cross Sectional ◽  
Pain Scores ◽  
Body Regions

Abstract Objective The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain scale quantifies knee pain severity with activities of daily living, but the potential impact of pain in other body regions on WOMAC pain scores has not been explored using a causal modeling approach. The purpose of this study was to determine if pain in other areas of the body impact WOMAC pain scores, a phenomenon referred to as “crosstalk.” Methods Cross-sectional datasets were built from public use data available from the Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis Study (MOST). The WOMAC Pain Scale and generic hip, knee, ankle, foot and back pain measures were included. Three nested regression models grounded in causally based classical test theory determined the extent of crosstalk. Improvements in the coefficient of determination across the 3 models were used to determine the presence of crosstalk. Results Causal modeling provided evidence of crosstalk in both OAI and MOST datasets. For example, in OAI, multiple statistical models demonstrated significant increases in coefficient of determination values (P &lt; .0001) as additional pain areas were added to the models. Conclusions Crosstalk appears to be a clinically important source of error in the WOMAC Pain Scale, particularly for patients with a larger number of painful body regions and when contralateral knee joint pain is more severe. Impact Statement This study has important implications for arthritis research. It also should raise clinician awareness of the threat to score interpretation and the need to consider the extent of pain in other body regions when interpreting WOMAC pain scores.

scholarly journals Knee Pain During Daily Tasks, Knee Osteoarthritis Severity, and Widespread Pain

2014 ◽  
Vol 94 (4) ◽  
pp. 490-498 ◽  
Author(s):  
Daniel L. Riddle ◽  
Paul W. Stratford
Keyword(s):  
Knee Pain ◽  
Pain Scale ◽  
Womac Pain ◽  
Widespread Pain ◽  
Cross Sectional ◽  
Knee Oa ◽  
Bilateral Knee ◽  
Scale Scores ◽  
Cross Sectional Design ◽  
High Level

Background The presence of widespread pain is easily determined and is known to increase the risk for persistent symptoms. Objective The study hypothesis was that people with no or minimal knee osteoarthritis (OA) and high Western Ontario and McMaster Universities (WOMAC) Pain Scale scores would be more likely than other subgroups to report widespread pain. Design A cross-sectional design was used. Methods Data were obtained from the Multicenter Osteoarthritis Study, which includes people with or at high risk for knee OA. The inclusion criteria were met by 755 people with unilateral knee pain and 851 people with bilateral knee pain. Widespread pain was assessed with body diagrams, and radiographic Kellgren-Lawrence grades were recorded for each knee. Knee pain during daily tasks was quantified with WOMAC Pain Scale scores. Results Compared with people who had high levels of pain and knee OA, people with a low level of pain and a high level of knee OA, and people with low levels of pain and knee OA, a higher proportion of people with a high level of knee pain and a low level of knee OA had widespread pain. This result was particularly true for people with bilateral knee pain, for whom relative risk estimates ranged from 1.7 (95% confidence interval=1.2–2.4) to 2.3 (95% confidence interval=1.6–3.3). Limitations The cross-sectional design was a limitation. Conclusions People with either no or minimal knee OA and a high level of knee pain during daily tasks are particularly likely to report widespread pain. This subgroup is likely to be at risk for not responding to knee OA treatment that focuses only on physical impairments. Assessment of widespread pain along with knee pain intensity and OA status may assist physical therapists in identifying people who may require additional treatment.

scholarly journals POS1465-HPR THE RELATIONSHIP BETWEEN SEDENTARY BEHAVIOR AND SLEEP IN RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1017.2-1018
Author(s):  
N. Kelly ◽  
E. Hawkins ◽  
H. O’leary ◽  
K. Quinn ◽  
G. Murphy ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Sleep Quality ◽  
Sedentary Behavior ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
P Value ◽  
Poor Sleep ◽  
Cross Sectional ◽  
The Relationship

Background:Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory condition that affects 0.5% of the adult population worldwide (1). Sedentary behavior (SB) is any waking behavior characterized by an energy expenditure of ≤1.5 METs (metabolic equivalent) and a sitting or reclining posture, e.g. computer use (2) and has a negative impact on health in the RA population (3). Sleep is an important health behavior, but sleep quality is an issue for people living with RA (4, 5). Poor sleep quality is associated with low levels of physical activity in RA (4) however the association between SB and sleep in people who have RA has not been examined previously.Objectives:The aim of this study was to investigate the relationship between SB and sleep in people who have RA.Methods:A cross-sectional study was conducted. Patients were recruited from rheumatology clinics in a large acute public hospital serving a mix of urban and rural populations. Inclusion criteria were diagnosis of RA by a rheumatologist according to the American College of Rheumatology criteria age ≥ 18 and ≤ 80 years; ability to mobilize independently or aided by a stick; and to understand written and spoken English. Demographic data on age, gender, disease duration and medication were recorded. Pain and fatigue were measured by the Visual Analogue Scale (VAS), anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), and sleep quality was assessed using the Pittsburgh Sleep Quality Index. SB was measured using the ActivPAL4™ activity monitor, over a 7-day wear period. Descriptive statistics were calculated to describe participant characteristics. Relationships between clinical characteristics and SB were examined using Pearson’s correlation coefficients and regression analyses.Results:N=76 participants enrolled in the study with valid data provided by N=72 participants. Mean age of participants was 61.5years (SD10.6) and the majority 63% (n = 47) were female. Participant mean disease duration was 17.8years (SD10.9). Mean SB time was 533.7 (SD100.1) minutes (8.9 hours per day/59.9% of waking hours). Mean sleep quality score was 7.2 (SD5.0) (Table 1). Correlation analysis and regression analysis found no significant correlation between sleep quality and SB variables. Regression analysis demonstrated positive statistical associations for SB time and body mass index (p-value=0.03846, R2 = 0.05143), SB time and pain VAS (p-value=0.009261, R2 = 0.07987), SB time and HADS (p-value = 0.009721, R2 = 0.08097) and SB time and HADSD (p-value = 0.01932, R2 = 0.0643).Conclusion:We found high levels of sedentary behavior and poor sleep quality in people who have RA, however no statistically significant relationship was found in this study. Future research should further explore the complex associations between sedentary behavior and sleep quality in people who have RA.References:[1]Carmona L, et al. Rheumatoid arthritis. Best Pract Res Clin Rheumatol 2010;24:733–745.[2]Anon. Letter to the editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab = Physiol Appl Nutr Metab 2012;37:540–542.[3]Fenton, S.A.M. et al. Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity. BMC Musculoskelet Disord 18, 131 (2017).[4]McKenna S, et al. Sleep and physical activity: a cross-sectional objective profile of people with rheumatoid arthritis. Rheumatol Int. 2018 May;38(5):845-853.[5]Grabovac, I., et al. 2018. Sleep quality in patients with rheumatoid arthritis and associations with pain, disability, disease duration, and activity. Journal of clinical medicine, 7(10)336.Table 1.Sleep quality in people who have RASleep variableBed Time N(%) before 10pm13(18%) 10pm-12pm43 (60%) after 12pm16 (22%)Hours Sleep mean(SD)6.56 (1.54)Fall Asleep minutes mean(SD)33.3(27.7)Night Waking N(%)45(63%)Self-Rate Sleep mean(SD)2.74 (0.90)Hours Sleep mean(SD)6.56 (1.54)Disclosure of Interests:None declared

scholarly journals The multimorbidity of hypertension and osteoarthritis and relation with sleep quality and hyperlipemia/hyperglycemia in China’s rural population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Li Ran ◽  
Qi Chen ◽  
Jingyi Zhang ◽  
Xinlong Tu ◽  
Xiaodong Tan ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Regression Models ◽  
Joint Effect ◽  
Cross Sectional Study ◽  
Poor Sleep ◽  
Sectional Study ◽  
Additive Interaction ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Remote Rural Area

AbstractHypertension (HTN) and osteoarthritis (OA) are frequent in middle-aged and elderly people, and the co-occurrence of these two diseases is common. However, the pathogenesis of the multimorbidity of both diseases and the relation with sleep quality, hyperlipemia, and hyperglycemia is unclear. We conducted a cross-sectional study to make sense of the multimorbidity of HTN and OA and the relation with sleep quality, hyperlipemia, and hyperglycemia. The relation between sleep quality and OA and its joint effect with hyperlipemia or hyperglycemia was evaluated with logistic regression models. The additive interaction was assessed with the relative excess risk due to interaction (REEI), the attributable proportion (AP), and the synergy index (S). According to this research in a remote rural area, approximately 34.2% of HTN patients are accompanied with OA and 49.1% are suffering poor sleep. Both hyperlipemia/hyperglycemia and sleep quality were related to OA prevalence with crude ORs of 1.43 (95% CI 1.014–2.029) and 1.89 (95% CI 1.411–2.519, P < 0.001) respectively. An observed additive effect was found greater than the sum of the effects of sleep quality and hyperlipemia/hyperglycemia posed on OA prevalence alone. This additive interaction was observed in females (OR = 3.19, 95% CI 1.945–5.237) as well as males ≥ 65 years old (OR = 2.78, 95% CI 1.693–4.557), with RERI, AP, and S significant. Therefore, poor sleep and hyperlipemia/hyperglycemia are associated with OA, and further studies on the additive interaction among females and males ≥ 65 are warranted.

scholarly journals HUBUNGAN ANTARA ASUPAN ENERGI DENGAN STATUS GIZI MAHASISWA PROGRAM STUDI PENDIDIKAN DOKTER ANGKATAN 2013 FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Irene Ubro
Keyword(s):  
Energy Intake ◽  
Significant Relationship ◽  
Nutrient Intake ◽  
The Body ◽  
Nutrition Status ◽  
Rank Test ◽  
P Value ◽  
Cross Sectional ◽  
Spearman Rank ◽  
The Relationship

Abstract: Humans need a certain amount of energy in order to support the growth and activity. Energy can arise due to combustion derived from carbohydrates, fats and proteins in foods consumed by the body, therefore to have enough energy one should consume enough and balanced food.Nutritional status is a state of the body that is the final result of a balance between the nutrients into the body and its utilization. Adolescence (10-19 years) is a period that is often prone to nutritional problems, because in this period there is less and over nutrient intake. This study aims to determine the relationship between energy intake and Student’s Nutrition Status of  Faculty of Medical Education, University of Sam Ratulangi Manado Year 2013. This study was an observational analytic using cross - sectional approach. Results of statistical analysis using the Spearman rank test shows that, the value of the correlation coefficient (r) of - 0.234 on IMT and 0.077 on WHR and p value of < α = 0.05 on IMT and 0.514 > α = 0.05 on WHR. From the results it is concluded that there is a significant relationship between energy intake with BMI, while the relationship between energy intake with WHR there is no significant relationship. Keywords : Energy Intake, Nutritional Status    Abstrak: Manusia membutuhkan energi dalam jumlah tertentu guna untuk menunjang proses pertumbuhan dan melakukan aktifitas. Energi dapat timbul karena adanya pembakaran yang diperoleh dari karbohidrat, lemak dan protein dalam makanan yang di konsumsi oleh tubuh, karena itu agar energi tercukupi perlu  mengkonsumsi makanan yang cukup dan seimbang. Status gizi adalah keadaan tubuh yang merupakan hasil akhir dari keseimbangan antara zat gizi yang masuk ke dalam tubuh dan utilisasinya.Masa remaja (10-19 tahun) merupakan masa yang sering rentan terhadap masalah gizi, dikarenakan pada masa ini terjadi asupan gizi kurang dan asupan gizi lebih. Penelitian ini bertujuan untuk mengetahui hubungan asupan energi dengan status gizi pada mahasiswa Program Studi Pendidikan Dokter Angkatan 2013 Fakultas Kedokteran Universitas Sam Ratulangi Manado. Penelitian ini bersifat observasional analitik dengan menggunakan pendekatan cross-sectional (potong lintang). Kesimpulan: Hasil analisis statistik dengan menggunakan uji spearman rank menunjukkan bahwa, nilai koefisien korelasi (r) sebesar -0,234 pada IMT dan 0,077 pada WHR serta nilai p sebesar < α = 0,05 pada IMT dan 0,514 > α = 0,05 pada WHR. Dari hasil tersbut disimpulkan bahwa ada hubungan bermakna antara asupan energi dengan IMT sedangkan hubungan antara asupan energi dengan WHR tidak terdapat hubungan yang bermakna. Kata Kunci : Asupan Energi, Status Gizi

scholarly journals The relationship between sleep hygiene and sleep quality among residents of an elderly care institution in DKI Jakarta

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Mutia Annisa ◽  
Dwi Nurviyandari Kusuma Wati
Keyword(s):  
Sleep Quality ◽  
Sleep Problems ◽  
Elderly Care ◽  
Sleep Hygiene ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
The Relationship ◽  
Purposive Sample

<p class="AbstractContent"><strong>Objective:</strong> Elderly are at risk of poor slepp quality and other health problems due to reduced sleep satisfaction. The objective of this study was to explore the association between sleep hygiene and sleep quality in elderly.</p><p class="AbstractContent"><strong>Methods: </strong>This was a descriptive study with cross sectional design. The study was conducted in four elderly care institutions in Jakarta, Indonesia, involving a purposive sample of 103 elderly aged 60 to 111 years old. Data were collected using Sleep Hygiene Index (SHI) and Pittsburgh Sleep Quality Index (PSQI).</p><p class="AbstractContent"><strong>Results:</strong> Over half of the residents had poor sleep hygiene (51.5%) and more than three quarter (81.6%) had poor sleep quality. The study revealed that there was a highly significant relationship between sleep hygiene and sleep quality (p = 0.001). The study also showed that those with poor sleep hygiene were 7.834 times more likely to have poor sleep quality.<strong></strong></p><p class="AbstractContent"><strong>Conclusion: </strong>Nurses need to include interventions that may address residents’ sleep problems. They also need to promote sleep hygiene and improve residents’ sleep quality.<strong></strong></p><strong>Keywords: </strong>elderly, institution, sleep hygiene, sleep quality

IS DISTRIBUTION OF PAIN RELATED WITH CENTRAL SENSITIZATION IN PATIENTS WITH LOWER LIMB OSTEOARTHRITIS?

2021 ◽  
pp. 2150019
Author(s):  
Andriana Koufogianni ◽  
Asimakis K. Kanellopoulos ◽  
Konstantinos Vassis ◽  
Ioannis A. Poulis
Keyword(s):  
Lower Limb ◽  
Central Sensitization ◽  
Rating Scale ◽  
Cross Sectional Study ◽  
The Body ◽  
Cross Sectional ◽  
Numeric Pain Rating Scale ◽  
The Relationship ◽  
Pain Distribution

Design: Cross-sectional study. Background: Osteoarthritis is one of the most common conditions in our society. A growing number of studies suggest the existence of central sensitization (CS) in a subgroup of osteoarthritic patients. One of the criteria included for the classification of CS pain is the expanded distribution of pain. As this criterion is a well-recognized sign of CS, a digital pain drawing (DPD) analysis would be useful to easily identify possible extended areas of pain distribution (PD) in patients with OA. Objective: To study the relationship between the percentage of distribution of pain in the lower limb for both knee and hip, in patients before hip or knee arthroplasty, and the Central Sensitization Inventory Questionnaire. Methods: Twenty women (mean [Formula: see text] years) with diagnosed chronic (over 3 months) knee ([Formula: see text]) and hip ([Formula: see text]) OA participated in the study, with intensity of pain from mild to severe, meaning pain [Formula: see text]/10 using the Numeric Pain Rating Scale (NPRS). The PD was analyzed via software created for this research, called “Pain Distribution Application”. Results: A statistically significant positive correlation between CSI and PD to the lower extremity OA (hip and knee) ([Formula: see text], [Formula: see text]) was found. The distribution of pain has a linear correlation with the results in CSI, of patients who tested positive for CS, i.e. with a score of [Formula: see text]. Conclusions: As the distribution of pain on the surface of the body (diffusion) increases, so does the score of people who test positive for CSI. Our results showed that calculating the distribution of pain with our application may have a utility as a CS screening tool. The PD threshold of 10% of the body area is an index for CS for chronic pain lower limb OA patients.

Revised chronic widespread pain criteria: development from and integration with fibromyalgia criteria

2019 ◽  
Vol 20 (1) ◽  
pp. 77-86 ◽  
Author(s):  
Frederick Wolfe ◽  
Stephen H. Butler ◽  
MaryAnn Fitzcharles ◽  
Winfried Häuser ◽  
Robert L. Katz ◽  
...  
Keyword(s):  
Functional Disability ◽  
Clinical Symptoms ◽  
Clinical Care ◽  
Chronic Widespread Pain ◽  
The Body ◽  
Clinical Severity ◽  
Widespread Pain ◽  
Effective Measure ◽  
American College Of Rheumatology ◽  
Pain Site

AbstractBackground and aimsPersons with chronic widespread pain (CWP) have poor medical outcomes and increased mortality. But there are no universally accepted criteria for CWP or of methods to assess it. The most common criteria come from the 1990 American College of Rheumatology (ACR) fibromyalgia (FM) criteria, but that method (WP1990) can identify CWP with as few as three pain sites, and in subjects with wide differences in illness severity. Recently, to correct WP1990 deficiencies, the 2016 fibromyalgia criteria provided a modified CWP definition (WP2016) by dividing the body into five regions of three pain sites each and requiring a minimum of four regions of pain. Although solving the geographic problem of pain distribution, the problem of just how many pain sites (pain diffuseness) are required remained a problem, as WP2016 required as few as four painful sites. To better characterize CWP, we compared four CWP definitions with respect to symmetry, extent of pain sites and association with clinical severity variables.MethodsWe characterized pain in 40,960 subjects, including pain at 19 individual sites and five pain regions, and calculated the widespread pain index (WPI) and polysymptomatic distress scales (PDS) from epidemiology, primary care and rheumatology databases. We developed and evaluated a new definition for CWP, (WP2019), defined as pain in four or five regions and a pain site score of at least seven of 15 sites. We also tested a definition based on the number of painful sites (WPI ≥ 7).ResultsIn rheumatology patients, WP1990 and WPI ≥ 7 classified patients with <4 regions as WSP. CWP was noted in 51.3% by WP1990, 41.7% by WP2016, 37.6% of WPI ≥ 7 and 33.9% by WP2019. 2016 FM criteria was satisfied in WP1990 (51.1%), WP2016 (63.3%), WPI ≥ 7 (69.0%) and WP2019 (76.6%). WP2019 positive patients had more severe clinical symptoms compared with WP1990, WP2016 and WPI ≥ 7, and similar to but less than FM 2016 positive patients. In stepwise fashion, scores for functional disability, visual analog scale fatigue and pain, WPI, polysymptomatic distress score and Patient Health Questionnaire 15 (PHQ-15) worsened from WP1990 through WP2016, WPI ≥ 7 and WP2019.ConclusionsWP2019 combines the high WPI scores of WPI ≥ 7 and the symmetry of WP2016, and is associated with the most abnormal clinical scores. The WP1990 does not appear to be an effective measure. We suggest that CWP can be better defined by combining 4-region pain and a total pain site score ≥7 (WP2019). This definition provides a simple, unambiguous measure that is suitable for clinical and research use as a standalone diagnosis that is integrated with fibromyalgia definitions.ImplicationsDefinitions of CWP in research and clinic care are arbitrary and have varied, and different definitions of CWP identify different sets of patients, making a universal interpretation of CWP uncertain. In addition, CWP is a mandatory component of some fibromyalgia criteria. Our study provides quantitative data on the differences between CWP definitions and their criteria, allowing better understanding of research results and a guide to the use of CWP in clinical care.

scholarly journals A survey of caregiver acculturation and acceptance of silver diamine fluoride treatment for childhood caries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anjali Kumar ◽  
Dana Cernigliaro ◽  
Mary E. Northridge ◽  
Yinxiang Wu ◽  
Andrea B. Troxel ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
The United States ◽  
Cross Sectional Study ◽  
Caries Experience ◽  
Cross Sectional ◽  
Silver Diamine Fluoride ◽  
Fluoride Treatment ◽  
Logistic Regression Models ◽  
Health Related ◽  
The Relationship

Abstract Background Interest in aqueous silver diamine fluoride (SDF) has been growing as a treatment for caries arrest. A cross-sectional study was conducted to identify factors associated with caregiver acceptance of SDF treatment for children presenting with caries at 8 Federally Qualified Health Centers. The study purpose was to examine associations between caregiver acceptance of SDF treatment for children with caries and (1) sociodemographic and acculturation characteristics of caregivers and (2) clinical assessments of the children by dentists. Methods A caregiver survey collected information on: sociodemographic characteristics; acculturation characteristics, measured using the validated Short Acculturation Scale for Hispanics (SASH); perceived benefits and barriers of SDF treatment, including caregiver comfort; and perceived health-related knowledge. Chart reviews were conducted to assess: the medical / dental insurance of pediatric patients; cumulative caries experience, measured using decayed, missing, filled teeth total scores (dmft / DMFT); whether operating room treatment was needed; and a record of caregiver acceptance of SDF treatment (the outcome measure). Standard logistic regression models were developed for caregiver acceptance of SDF treatment for their children as the binary outcome of interest (yes / no) to calculate unadjusted odds ratios (OR) and adjusted ORs for covariates of interest. Results Overall, 434 of 546 caregivers (79.5%) accepted SDF treatment for their children. A U-shaped relationship between caregiver odds of accepting SDF treatment and age group of pediatric patients was present, where caregivers were most likely to accept SDF treatment for their children who were either < 6 years or 9–14 years, and least likely to accept SDF treatment for children 6 to < 9 years. The relationship between acculturation and caregiver acceptance of SDF treatment depended upon whether or not caregivers were born in the United States: greater acculturation was associated with caregiver acceptance of SDF treatment among caregivers born in this country, and lower acculturation was associated with caregiver acceptance of SDF treatment among caregivers born elsewhere. Conclusions Caregiver acceptance of SDF treatment is high; child’s age and caregiver comfort are associated with acceptance. Providers need to communicate the risks and benefits of evidence-based dental treatments to increasingly diverse caregiver and patient populations.

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